MEDICARE: COVENANT CARE CALIFORNIA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	080000102	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659369262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVENANT CARE CALIFORNIA, LLC

Provider Business Mailing Address
First Line	:	1025 WEST 2ND AVENUE
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92025-3839
Country	:	US
Telephone Number	:	760-745-1842
Fax Number	:	760-745-4346

Provider Business Practice Location Address
First Line	:	1025 WEST 2ND AVENUE
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92025-3839
Country	:	US
Telephone Number	:	760-745-1842
Fax Number	:	760-745-4346

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	CAROL SPARKS
Credential	:
Telephone Number	:	949-349-1200

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	02/03/2014

Similar Medicare Providers

1114375060 — CALIFORNIA EMERGENCY PHYSICIANS MEDICAL GROUP, A PROFESSIONAL CORPORAT
Practice Location Address:

1025 W 2ND AVE
ESCONDIDO, CA
92025-3839

Practice Phone: 760-745-1842
Practice Fax:

1548767726 — ANDYSHEH KAMGAR-PARSI
Practice Location Address:

1025 W 2ND AVE
ESCONDIDO, CA
92025-3839

Practice Phone: 872-231-3162
Practice Fax:

1962239590 — KELLOGG BEACH HOLDINGS LLC
Practice Location Address:

1025 W 2ND AVE
ESCONDIDO, CA
92025-3839

Practice Phone: 760-745-1842
Practice Fax:

1790107415 — RUTH ELAINE VAN HASSELT SLP
Practice Location Address:

2119 VALLEY RIM GLN
ESCONDIDO, CA
92026-3839

Practice Phone: 760-290-3530
Practice Fax:

1891685343 — JANETTE ROSE ETCHINGS
Practice Location Address:

255 N ELM ST STE 203
ESCONDIDO, CA
92025-3431

Practice Phone: 619-613-7880
Practice Fax:

1619010550 — MENTAL HEALTH SYSTEMS, INC.
Practice Location Address:

474 W VERMONT AVE STE 103&104
ESCONDIDO, CA
92025-6584

Practice Phone: 760-432-9884
Practice Fax: 760-432-9953

Directions to “COVENANT CARE CALIFORNIA, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.